Provider Demographics
NPI:1386212215
Name:PASTRANA, LEONARD (PHARM D)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:PASTRANA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13860 WELLINGTON TRCE STE 38-126
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8588
Mailing Address - Country:US
Mailing Address - Phone:561-603-0409
Mailing Address - Fax:
Practice Address - Street 1:8170 OKEECHOBEE BLVD STE 4
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2159
Practice Address - Country:US
Practice Address - Phone:561-603-0409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS434401835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist